I give up to figuring her out. Never would have guessed this PMPS. She does seem to have longer duration at night and of course mostly pinks PMPS.
AMCNY called and we had a lengthy discussion. In a nutshell more information is needed on the abdominal mass. Olive is due next month for repeat echo and abdominal ultrasound. If the mass has not changed in any way (sizs, shape, location) then it' probably can move forward. I'm still paying for the 1st ones. If tumor is removed it means life long hormone supplementation. If the pancreas has not been damaged the diabetes could reverse or at least lower insulin doses. Not knowing if the hcm is acro induced or genetic she will probably always have it. Because of it her hospitalization would be longer and she could go into heart failure anytime during recovery while balancing the supplement hormones.
He did say the cabergoline is a viable option. If I can find a good IM who is willing to work in conjunction with their endocrinologist regarding dosage and treatment. This is probably what I will do as the other is to risky.